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Renal scarring and urinary tract infection after successful endoscopic correction of vesicoureteral reflux.

Publication ,  Journal Article
Chertin, B; Natsheh, A; Fridmans, A; Shenfeld, OZ; Farkas, A
Published in: J Urol
October 2009

PURPOSE: We evaluated renal function and the incidence of urinary tract infection after successful endoscopic correction of vesicoureteral reflux. MATERIALS AND METHODS: From 1988 to 2007, 169 male and 338 female patients (696 refluxing renal units) with a median age of 3.7 years underwent successful endoscopic correction of primary vesicoureteral reflux using polytetrafluoroethylene and dextranomer/hyaluronic acid copolymer. Reflux was grades I to V in 36 (5.2%), 178 (25.6%), 298 (42.7%), 163 (23.4%) and 21 refluxing renal units (3.1%), respectively. Renal ultrasound and (99m)technetium-dimercaptosuccinic acid scan were performed in all patients preoperatively, and in all patients and in 509 of 696 refluxing renal units (73%) postoperatively, respectively. All patients were followed 1 to 20 years (median 13). RESULTS: Preoperatively (99m)technetium-dimercaptosuccinic acid scan revealed scarring in 543 of 696 refluxing renal units (78%). Reflux resolved after 1 injection in 473 refluxing renal units (68%), in 161 (23%) after 2 and in 25 ureters (3.6%) after 3. In 37 refluxing renal units (5.4%) reflux improved to grade I, which required no further treatment. Renal deterioration was noted in 11 of 26 refluxing renal units with initially severe renal scarring (less than 20% uptake on (99m)technetium-dimercaptosuccinic acid scan). The remaining refluxing renal units in this group showed an insignificant 2.3% change in relative function after successful reflux correction (p >0.005). Patients with vesicoureteral reflux downgrading did not show new renal scars. Of the remaining 446 refluxing renal units 27 (6.1%) showed a greater than 5% decrease in relative function without new scarring. Eight children in the polytetrafluoroethylene group and 3 in the dextranomer/hyaluronic acid copolymer group (overall 2.2%) had febrile urinary tract infection after successful endoscopic correction, leading to reevaluation that resulted in the diagnosis of recurrent reflux in 8 (72.7%). A total of 28 children (5.6%) had afebrile urinary tract infection without recurrent vesicoureteral reflux. CONCLUSIONS: Our data show that successful endoscopic correction of vesicoureteral reflux is accompanied by a low incidence of new renal scarring and febrile urinary tract infection. Patients who initially have corrected reflux but who have a febrile urinary tract infection at long-term followup require prompt revaluation to rule out recurrent reflux.

Duke Scholars

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

October 2009

Volume

182

Issue

4 Suppl

Start / End Page

1703 / 1706

Location

United States

Related Subject Headings

  • Vesico-Ureteral Reflux
  • Urology & Nephrology
  • Urinary Tract Infections
  • Ureteroscopy
  • Remission Induction
  • Postoperative Complications
  • Male
  • Kidney Diseases
  • Incidence
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chertin, B., Natsheh, A., Fridmans, A., Shenfeld, O. Z., & Farkas, A. (2009). Renal scarring and urinary tract infection after successful endoscopic correction of vesicoureteral reflux. J Urol, 182(4 Suppl), 1703–1706. https://doi.org/10.1016/j.juro.2009.03.011
Chertin, Boris, Alaeddin Natsheh, Alon Fridmans, Ofer Z. Shenfeld, and Amicur Farkas. “Renal scarring and urinary tract infection after successful endoscopic correction of vesicoureteral reflux.J Urol 182, no. 4 Suppl (October 2009): 1703–6. https://doi.org/10.1016/j.juro.2009.03.011.
Chertin B, Natsheh A, Fridmans A, Shenfeld OZ, Farkas A. Renal scarring and urinary tract infection after successful endoscopic correction of vesicoureteral reflux. J Urol. 2009 Oct;182(4 Suppl):1703–6.
Chertin, Boris, et al. “Renal scarring and urinary tract infection after successful endoscopic correction of vesicoureteral reflux.J Urol, vol. 182, no. 4 Suppl, Oct. 2009, pp. 1703–06. Pubmed, doi:10.1016/j.juro.2009.03.011.
Chertin B, Natsheh A, Fridmans A, Shenfeld OZ, Farkas A. Renal scarring and urinary tract infection after successful endoscopic correction of vesicoureteral reflux. J Urol. 2009 Oct;182(4 Suppl):1703–1706.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

October 2009

Volume

182

Issue

4 Suppl

Start / End Page

1703 / 1706

Location

United States

Related Subject Headings

  • Vesico-Ureteral Reflux
  • Urology & Nephrology
  • Urinary Tract Infections
  • Ureteroscopy
  • Remission Induction
  • Postoperative Complications
  • Male
  • Kidney Diseases
  • Incidence
  • Humans